Friday, 20 January 2006

When choosing a therapist, you’d be forgiven for wanting someone with plenty of experience. But then you might well be unaware of all the studies that, to psychotherapy’s embarrassment, have failed to find any association between therapist experience and the likelihood of a client getting better.

However, Scott Leon and colleagues have suggested that crude measures of therapist experience – such as ‘years since graduation’ – have rendered past research fundamentally flawed.

In their new study, they took advantage of a nationwide database of client outcomes collected over several years, to see if a client was more likely to get better if their therapist had previously engaged in therapy with someone demographically similar to themselves, and with similar problems.

From 2,366 clients treated by 92 therapists, Leon’s team identified 83 pairs of similar clients who had been treated by the same therapist. The researchers were specifically interested in whether, of the two clients in a matched pair, a therapist was more successful at treating the second of the two clients to come to them. As a control, 86 random pairs of clients were also compared. A client’s improvement was measured according to data that both they and their therapist inputted periodically onto the database.

Therapists did indeed tend to have more success with a client if they had previously treated someone similar, but only if the second client came to them within 15 to 75 days of the first. In contrast, therapists had no more, or less, success with second clients who started therapy between 75 and 720 days, or longer, after the first ‘similar’ client. The researchers said this suggests “…therapists can make use of prior experience with future similar patients, as long as the subsequent patients enter treatment shortly after the initial patient”.

What about the implications for therapist training? The researchers said: “If replicated, these findings could suggest that therapists gain from experience if they are allowed to treat similar types of patient in quick succession”. They added that the “…findings might provide support for a specialised training and practice model”.
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Leon, S.C., Martinovich, Z., Lutz, W. & Lyons, J.S. (2005). The effect of therapist experience on psychotherapy outcomes. Clinical Psychology and Psychotherapy, 12, 417-426.